Client Application

To confirm, you are filling this out because you want to lose between 10-25lbs (or more) of stubborn fat, regain energy, reset your metabolism, build lean & toned muscle + make this the LAST program/coaching you’ll ever need? *

Yes - I am serious, and want to learn more about reaching my dream body, without sacrificing my life.

No - I’m going to leave this page immediately.

First Name *

Last Name *

Age? *

Occupation? (Where do you work? Desk job? Active job? etc.) *

Which of the below best describes your goal(s)? *

I want to get my body back. I want to look and feel my best without sacrificing tons of time

I am mostly focused on losing the weight, I am done watching the scale go up every year

I want to address my habits and understand why my past attempts at “diet & exercise” have failed.

I want to get strong and have the energy to play with my kids again.

I’m not exactly sure what my specific goals are, but my attempts to improve my health are not working

Its time for me to make a change and set the example for my family. I need to make myself a priority so I can show up as my best self for them.

Other *List below

If your current health/fitness goals were not listed above, or you feel you want to explain further - please do so here

Please explain your 'WHY'. What is driving you to make these changes now? *

On a scale of 1-5, how ready / committed are you to changing your life right now? (1 being "not ready at all" and 5 being "I'll do anything to change my life") *

Do you have a significant other/partner? If so, are they supportive of you investing in your weight loss, health, and personal growth? *

Yes, I have a significant other and they are supportive AF.

Yes, I have a significant other but this is my decision to make.

Yes, I have a significant other but they may need to be on the call with me to make a joint decision.

No, I’m single AF and make my own rules, lol

If you were to find a way to reach your goal body, and learn how to keep your results for LIFE, making me the LAST coach you'll need to hire- would you be willing (and able) to invest in getting the help necessary to get you there? *

Yes, I have the cash flow to invest in myself

Yes, I may not have the cash flow, but I'm resourceful and have access to credit

No, my cash flow is month to month, and I have no access to credit

Space is very limited and I want to make sure this is a good fit, why do you think you would be a good addition to the program, if invited? *

Phone *

Email *

NEXT STEPS.... I will review your application and IF I feel like I can truly help you out would you be open to setting up a zoom call so we can run you through the details of how our coaching program works? *

Yes plz! I am READY to make a change

No thanks, I don't want 1:1 help I can do it on my own.

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We Will Review Your Application And We Will Be In Touch For Next Steps!